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Article ; Online: The Serious Illness Care Program in Oncology: Evidence, Real-World Implementation and Ongoing Barriers.

Karim, Safiya / Levine, Oren / Simon, Jessica

2022 Volume 29, Issue 3, Page(s) 1527–1536

Abstract: The Serious Illness Care Program (SICP), designed by Ariadne Labs, is a multicomponent intervention to improve conversations about values and goals for patients with a life-limiting illness. In oncology, implementation of the SICP achieved more, earlier, ...

Abstract	The Serious Illness Care Program (SICP), designed by Ariadne Labs, is a multicomponent intervention to improve conversations about values and goals for patients with a life-limiting illness. In oncology, implementation of the SICP achieved more, earlier, and better-quality conversations and reduced anxiety and depression among patients with advanced cancer. In this commentary, we describe the SICP, including results from the cluster-randomized trial, provide examples of real-world implementation of this program, and highlight ongoing challenges and barriers that are preventing widespread adoption of this intervention into routine practice. For the SICP to be successfully embedded into routine patient care, it will require significant effort, including ongoing leadership support and training opportunities, champions from all sectors of the interdisciplinary team, and adaptation of the program to a wider range of patients. Future research should also investigate how early conversations can be translated into personalized care plans for patients.
MeSH term(s)	Advance Care Planning ; Communication ; Critical Care ; Critical Illness ; Humans ; Medical Oncology
Language	English
Publishing date	2022-03-02
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol29030128
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Article ; Online: The ACTION Centre as a Model for Patient Engagement and Knowledge Translation in Integrative Oncology Practice, Training, and Research.

Carlson, Linda E / Karim, Safiya / Labelle, Laura E

Integrative cancer therapies

2022 Volume 21, Page(s) 15347354221103277

Abstract: Integrative Oncology (IO) programs are increasingly emerging at cancer centers and universities worldwide; often these include some combination of clinical service, research, and/or training. However, one gap that often occurs is in moving research ... ...

Abstract	Integrative Oncology (IO) programs are increasingly emerging at cancer centers and universities worldwide; often these include some combination of clinical service, research, and/or training. However, one gap that often occurs is in moving research results into practice, due to complexities and differences between research and service delivery models and priorities. We recently created the ACTION (Alberta Complementary Therapy and Integrative Oncology) Centre with the goal of partnering with the provincial public health service to promote and facilitate evidence-based integrative oncology care throughout Alberta. The Centre bridges the silos of academia and clinical care by embodying 3 core principles, to be (1) Patient-oriented, (2) Collaborative, and (3) Evidence-based. The ACTION Centre oversees the implementation of clinical research and academic training, and supports the development of clinical services, as well as patient and provider education. The ACTION Centre has five components which include: (1) Patient and healthcare provider education; (2) Individualized IO consultation and treatment planning; (3) Supporting access to complementary therapies; (4) Clinical trials of IO interventions, and; (5) Student training through the TRACTION (Training in Clinical Trials and Integrative Oncology) program. We offer this model of shareholder collaboration in the hopes that other IO programs may be able to use it as a template to further their own progress, working collaboratively toward the ultimate goal of advancing evidence-based, comprehensive, integrative healthcare to improve the lives of people affected by cancer.
MeSH term(s)	Complementary Therapies ; Humans ; Integrative Oncology ; Neoplasms/therapy ; Patient Participation ; Translational Science, Biomedical
Language	English
Publishing date	2022-06-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2182320-0
ISSN	1552-695X ; 1534-7354
ISSN (online)	1552-695X
ISSN	1534-7354
DOI	10.1177/15347354221103277
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Article ; Online: Effectiveness in the Absence of Efficacy: Cautionary Tales From Real-World Evidence.

Karim, Safiya / Booth, Christopher M

Journal of clinical oncology : official journal of the American Society of Clinical Oncology

2019 Volume 37, Issue 13, Page(s) 1047–1050

MeSH term(s)	Comparative Effectiveness Research/methods ; Data Collection/methods ; Electronic Health Records/statistics & numerical data ; Evidence-Based Medicine/methods ; Humans ; Insurance, Health/statistics & numerical data ; Neoplasms ; Patient Reported Outcome Measures ; Randomized Controlled Trials as Topic/statistics & numerical data
Language	English
Publishing date	2019-03-21
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	604914-x
ISSN	1527-7755 ; 0732-183X
ISSN (online)	1527-7755
ISSN	0732-183X
DOI	10.1200/JCO.18.02105
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Article ; Online: A Case Report of Anorectal Squamous Cell Carcinoma Associated with Overlap Myositis Syndrome-a Possible Paraneoplastic Myositis Syndrome.

Bosma, Nicholas A / Carter, Erin / Karim, Safiya

Clinical colorectal cancer

2021 Volume 20, Issue 2, Page(s) 148–152

MeSH term(s)	Carcinoma, Squamous Cell/complications ; Carcinoma, Squamous Cell/diagnosis ; Carcinoma, Squamous Cell/pathology ; Humans ; Myositis/complications ; Myositis/diagnosis ; Myositis/pathology ; Paraneoplastic Syndromes/complications ; Paraneoplastic Syndromes/diagnosis ; Paraneoplastic Syndromes/pathology ; Rectal Neoplasms/complications ; Rectal Neoplasms/diagnosis ; Rectal Neoplasms/pathology
Language	English
Publishing date	2021-02-19
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2112638-0
ISSN	1938-0674 ; 1533-0028
ISSN (online)	1938-0674
ISSN	1533-0028
DOI	10.1016/j.clcc.2021.02.004
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Article ; Online: Real World Implementation of the Serious Illness Care Program in Cancer Care: Results of a Quality Improvement Initiative.

Karim, Safiya / Lupichuk, Sasha / Tan, Amy / Sinnarajah, Aynharan / Simon, Jessica

Journal of palliative medicine

2021 Volume 24, Issue 6, Page(s) 905–909

Abstract: Purpose: ...

Abstract	Purpose:
MeSH term(s)	Advance Care Planning ; Communication ; Critical Care ; Critical Illness ; Humans ; Neoplasms ; Quality Improvement
Language	English
Publishing date	2021-01-12
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	1427361-5
ISSN	1557-7740 ; 1096-6218
ISSN (online)	1557-7740
ISSN	1096-6218
DOI	10.1089/jpm.2020.0680
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Article ; Online: Choosing Wisely-Barriers and Solutions to Implementation in Low and Middle-Income Countries.

Rubagumya, Fidel / Sengar, Manju / Ka, Sidy / Hammad, Nazik / Booth, Christopher M / Karim, Safiya

Current oncology (Toronto, Ont.)

2022 Volume 29, Issue 7, Page(s) 5091–5096

Abstract: Globally, there is increasing emphasis on value-based cancer care. Rising healthcare costs and reduced health care spending and budgets, especially in low- and middle-income countries (LMICs), call for patients, providers, and healthcare systems to apply ...

Abstract	Globally, there is increasing emphasis on value-based cancer care. Rising healthcare costs and reduced health care spending and budgets, especially in low- and middle-income countries (LMICs), call for patients, providers, and healthcare systems to apply the Choose Wisely (CW) approach. This approach seeks to advance a dialogue on avoiding unnecessary medical tests, treatments, and procedures. Several factors have been described as barriers and facilitators to the implementation of the Choosing Wisely recommendations in high-income countries but none for LMICs. In this review, we attempt to classify potential barriers to the Choose Wisely implementation relative to the sources of behavior and potential intervention functions that can be implemented in order to reduce these barriers.
MeSH term(s)	Delivery of Health Care ; Developing Countries ; Health Care Costs ; Humans ; Surveys and Questionnaires
Language	English
Publishing date	2022-07-19
Publishing country	Switzerland
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol29070403
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Article ; Online: Impact of Oncology Drug Review Times on Public Funding Recommendations.

Hussain, Marya / Wong, Chelsea / Taguedong, Eddy / Verma, Saurav / Mahsin, Md / Karim, Safiya / Lee-Ying, Richard / Ezeife, Doreen A

Current oncology (Toronto, Ont.)

2023 Volume 30, Issue 8, Page(s) 7706–7712

Abstract: New oncology drugs undergo detailed review prior to public funding in a single-payer healthcare system. The aim of this study was to assess how cancer drug review times impact funding recommendations. Drugs reviewed by the pan-Canadian Oncology Drug ... ...

Abstract	New oncology drugs undergo detailed review prior to public funding in a single-payer healthcare system. The aim of this study was to assess how cancer drug review times impact funding recommendations. Drugs reviewed by the pan-Canadian Oncology Drug Review (pCODR) between the years 2012 and 2020 were included. Data were collected including Health Canada approval dates, initial and final funding recommendations, treatment intent, drug class, clinical indications, and incremental cost-effectiveness ratios (ICER). Univariable and multivariable analyses were used to determine the association between funding recommendations and review times. Of the 164 applications submitted, 130 received a positive final recommendation. Median time from Health Canada (HC) approval to final recommendation was longer for drugs indicated for the treatment of gastrointestinal (GI) and lung cancer compared to breast, genitourinary (GU), and other tumours (205 vs. 198 vs. 111 vs. 129 vs. 181 days, respectively; Kruskal-Wallis
MeSH term(s)	Humans ; Canada ; Drug Utilization Review ; Lung Neoplasms ; Medical Oncology ; Single-Payer System
Language	English
Publishing date	2023-08-18
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	1236972-x
ISSN	1718-7729 ; 1198-0052
ISSN (online)	1718-7729
ISSN	1198-0052
DOI	10.3390/curroncol30080558
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Article ; Online: The Choosing Wisely Oncology Canada Cancer List: An Update.

Karim, Safiya / Doll, Corinne M / Dingley, Brittany / Merchant, Shaila J / de Moraes, Fabio Ynoe / Booth, Christopher M

Journal of cancer policy

2023 Volume 37, Page(s) 100431

Abstract: Background: Choosing Wisely (CW) Canada is a national campaign to identify unnecessary or harmful services that are frequently used in Canada. The original CW Oncology Canada Cancer list was developed in 2014. A CW Oncology Canada working group was ... ...

Abstract	Background: Choosing Wisely (CW) Canada is a national campaign to identify unnecessary or harmful services that are frequently used in Canada. The original CW Oncology Canada Cancer list was developed in 2014. A CW Oncology Canada working group was established to review new evidence and guidelines and to update the current CW Oncology Canada Cancer List. Methods: Between January and March 2022, we conducted a survey of members of the Canadian Association of Medical Oncology (CAMO), Canadian Association of Radiation Oncology (CARO) and the Canadian Society of Surgical Oncology (CSSO). We took the feedback from the survey, including potential new recommendations as well as those that were thought to be no longer relevant and up to date, and conducted a literature review with the assistance of the Canadian Agency for Drugs and Technology in Health (CADTH). The final updated list of recommendations was made by the CW Oncology Canada working group based on a consensus process. Results: We reviewed two potential recommendations to add and two potential recommendations to remove from the existing CW Oncology Canada Cancer List. The recommendation "Do not prescribe whole brain radiation over stereotactic radiosurgery for patient with limited brain metastases (≤4 lesions)" was supported by several evidence-based guidelines with the strength of recommendations ranging from strong to moderate and the quality of evidence ranging from level 1 to level 3. After reviewing the evidence, the working group felt that the other potential recommendation to add and the two potential recommendations to remove did not have sufficient strength and quality of evidence at this time to be added or removed from the list. Conclusion: The updated Choosing Wisely Oncology Canada Cancer List consists of 11 items that oncologists should question in the treatment of patients with cancer. This list can be used to design specific interventions to reduce low value care.
MeSH term(s)	Humans ; Canada ; Medical Oncology ; Consensus ; Radiation Oncology ; Brain Neoplasms
Language	English
Publishing date	2023-06-28
Publishing country	England
Document type	Review ; Journal Article
ISSN	2213-5383
ISSN (online)	2213-5383
DOI	10.1016/j.jcpo.2023.100431
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Article ; Online: Are the Choosing Wisely Canada Cancer recommendations relevant and up to date with the current evidence?

Karim, Safiya / Doll, Corinne M / Dingley, Brittany / Merchant, Shaila / de Moraes, Fabio Ynoe / Booth, Christopher M

Journal of cancer policy

2023 Volume 35, Page(s) 100406

Abstract: Introduction: The Choosing Wisely (CW) Canada campaign was launched in 2012 to identify low-value, unnecessary and/or harmful services that are frequently used. The CW Canada Cancer list was developed in 2014 by a task force convened by the Canadian ... ...

Abstract	Introduction: The Choosing Wisely (CW) Canada campaign was launched in 2012 to identify low-value, unnecessary and/or harmful services that are frequently used. The CW Canada Cancer list was developed in 2014 by a task force convened by the Canadian Partnership Against Cancer. The list outlines ten harmful or low-value practices that oncologists should avoid. We conducted a study of oncologists to understand the familiarity with the current recommendations and whether these continue to be relevant and up to date. Methods: An electronic survey was developed by the members of the CW Oncology Working Group and distributed to practicing oncologists. The survey consisted of questions on 1) the familiarity of the existing CW Canada Cancer list 2) the relevance of the current list to current evidence and 3) any recommendation(s) that could be added or removed from the existing list. Descriptive statistics were used to analyze responses and narrative analysis was used to identify themes in open-ended questions. Results: Between January 14 and May 3, 2022, 151 survey responses were received (overall response rate of 20 %) from 68 medical oncologists (45 % of study cohort, response rate 32 %), 54 radiation oncologists (36 % of study cohort, response rate 14 %) and 29 surgical oncologists (19 % of study cohort, response rate 18 %). Seventy-nine percent (120/151) of respondents were familiar with the current list and 65 % (78/119) said they implemented the recommendations "always" or "most of the time". Eight recommendations had > 80 % agreement that they were relevant and up to date with current evidence. There was interest in adding a new recommendation to avoid whole brain radiation and consider stereotactic radiosurgery (SRS) in patients with ≤ 4 brain metastases. Conclusions: There is excellent familiarity with the CW Canada Cancer list amongst the survey respondents and most recommendations continue to be relevant and up to date with current evidence. There is an opportunity to educate physicians about the intent of the campaign and to add a new recommendation on the use of SRS for patients with a limited number of brain metastases. There is also an opportunity to identify barriers at the patient, provider and institution level that are hindering adoption of the CW Canada Cancer list POLICY SUMMARY: This survey will impact implementation and publication of an updated CW Canada Cancer list.
MeSH term(s)	Humans ; Canada ; Medical Oncology ; Surveys and Questionnaires ; Brain Neoplasms
Language	English
Publishing date	2023-01-21
Publishing country	England
Document type	Journal Article
ISSN	2213-5383
ISSN (online)	2213-5383
DOI	10.1016/j.jcpo.2023.100406
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Article ; Online: Real-world data: towards achieving the achievable in cancer care.

Booth, Christopher M / Karim, Safiya / Mackillop, William J

Nature reviews. Clinical oncology

2019 Volume 16, Issue 5, Page(s) 312–325

Abstract: The use of data from the real world to address clinical and policy-relevant questions that cannot be answered using data from clinical trials is garnering increased interest. Indeed, data from cancer registries and linked treatment records can provide ... ...

Abstract	The use of data from the real world to address clinical and policy-relevant questions that cannot be answered using data from clinical trials is garnering increased interest. Indeed, data from cancer registries and linked treatment records can provide unique insights into patients, treatments and outcomes in routine oncology practice. In this Review, we explore the quality of real-world data (RWD), provide a framework for the use of RWD and draw attention to the methodological pitfalls inherent to using RWD in studies of comparative effectiveness. Randomized controlled trials and RWD remain complementary forms of medical evidence; studies using RWD should not be used as substitutes for clinical trials. The comparison of outcomes between nonrandomized groups of patients who have received different treatments in routine practice remains problematic. Accordingly, comparative effectiveness studies need to be designed and interpreted very carefully. With due diligence, RWD can be used to identify and close gaps in health care, offering the potential for short-term improvement in health-care systems by enabling them to achieve the achievable.
MeSH term(s)	Comparative Effectiveness Research/standards ; Electronic Health Records ; Humans ; Neoplasms/therapy ; Randomized Controlled Trials as Topic ; Registries
Language	English
Publishing date	2019-01-30
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2491410-1
ISSN	1759-4782 ; 1759-4774
ISSN (online)	1759-4782
ISSN	1759-4774
DOI	10.1038/s41571-019-0167-7
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